Individual provider Active NPI

Joseph William Gorvetzian, MD

  • Plastic and Reconstructive Surgery Physician
  • Albuquerque, NM
National Provider Identifier
1780245803
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD2025-0625 Issued in NM
Practice address
5203 Juan Tabo Blvd NE
Albuquerque, NM 87111-2683
Phone
(505) 299-4900
NPI assigned
Jun 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MD2025-0625 NM Primary

Addresses

Primary practice location

5203 Juan Tabo Blvd NE
Albuquerque, NM 87111-2683

Mailing address

5203 Juan Tabo Blvd NE
Albuquerque, NM 87111-2683
Phone (505) 299-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827003039 NM Practitioner - Plastic and Reconstructive Surgery 7113255431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

6701 Jefferson St NE
Albuquerque, NM 87109-4318
Phone (505) 727-6200

Hospital & facility affiliations

  • Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2025-0625NMMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Aug 13, 2025 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Aug 13, 2025 Accepting new patients
Spectrum Health Hospitals PastSince Feb 1, 2025 Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

4705 Montgomery Blvd NE
Ste 301
Albuquerque, NM 87109
Phone (505) 727-4500

6701 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 727-0600

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1780245803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112683",
            "telephone_number": "505-299-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 JUAN TABO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112683",
            "telephone_number": "505-299-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORVETZIAN",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-28",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NM",
            "license": "MD2025-0625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.